Impact of neuroendocrine morphology on cancer outcomes and stage at diagnosis: a UK nationwide cohort study 2013–2015
Genus T., Bouvier C., Wong K., Srirajaskanthan R., Rous B., TALBOT D., Valle J., Khan M., Pearce N., Elshafie M., Reed N., Morgan E., Deas A., White C., Huws D., Ramage J.
Background The diagnosis of neuroendocrine neoplasms (NENs) is often delayed. This first UK population-based epidemiological study of NENs compares outcomes with non-NENs to identify any inequalities. Methods Age-standardised incidence rate (ASR), 1-year overall survival, hazard ratios, and standardised mortality rates (SMRs) were calculated for all malignant NENs diagnosed 2013–2015 from UK national Public Health records. Comparison with non-NENs assessed 1-year overall survival (1YS) and association between diagnosis at stage IV and morphology. Results A total of 15 222 NENs were identified, with an ASR (2013–2015 combined) of 8·6 per 100 000 (95% CI 8·5–8·7); 4·6 per 100 000 (95% CI, 4·5–4·7) for gastro-entero-pancreatic (GEP) NENs. The 1YS was 75% (95% CI, 73·9–75.4) varying significantly by sex. Site and morphology were prognostic. NENs (predominantly small cell carcinomas) in the oesophagus, bladder, prostate, and female reproductive organs had a poorer outcome and were three times more likely to be diagnosed at stage IV than non-NENs. Conclusion Advanced stage at diagnosis with significantly poorer outcomes of some NENs compared with non-NENs at the same anatomical site, highlight the need for improved access to specialist services and targeted service improvement